Introduction Dyspnoea is a common and potentially debilitating symptom experienced by patients with chronic respiratory disease (CRD). Anxiety can also form a significant component of subjective dyspnoea. The management of dyspnoea in patients with CRD is multifaceted. Pharmacological agents such as opioids and benzodiazepines have been shown to be safe and effective at improving dyspnoea. This quality improvement project looked to assess and improve the prevalence of the prescribing of these pharmaceutical agents for symptomatic relief in CRD in Calderdale Royal Hospital (CRH), UK.

Methods CRD was defined as any patient with a diagnosis of lung cancer, chronic obstructive pulmonary disease, bronchiectasis or interstitial lung disease. Initial data collection was between 30/01–05/03/23 and assessed, once weekly, the number of inpatients with CRD prescribed an as-required opioid or benzodiazepines on the respiratory wards at CRH. Interventions were then undertaken to improve the prevalence of symptomatic relief prescribing. These centred around education and encouragement and included announcements at nursing and clinician handovers, formal teaching sessions, email communications and departmental posters. This was followed by a further 5-week period of data collection (06/03–09/04/23).

Results 257 patient records were interrogated (143 pre intervention, 114 post intervention). The prevalence of opioid or benzodiazepines prescribed for symptomatic relief in the target population improved from 56 (39%) to 68 (57%) between the two periods of data collection.

Conclusion Prescribing of pharmaceutical agents to provide symptomatic relief for dyspnoea increased after the study interventions. Following discussions with the palliative care team and IT services a template was created for both oral morphine and oxycodone for symptomatic relief of breathlessness in chronic respiratory diseases to further increase awareness amongst prescribers. The impact of this may serve as the basis of future quality improvement project as well as analysing the frequency of administration of these prescribed medications.